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MODULE TWELVE

Youth & Recovery

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That which does not kill us makes us stronger.


- Friedrich Nietzsche



Module Six
Youth & Recovery

In Module Six, you will learn

What is Recovery High School?

Consequences

Underage Drinking as a National Priority

Legal and Regulatory Issues

Categories of Abuse & Drug Abuse Facts

General Signs and Symptoms of Substance Use or Abuse

Coaches Role (Adult or Peer Coaching)

CRAFFT Screening Instrument for Adolescents

Useful Websites

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In 2006, state-funded recovery high schools for students with substance use disorders
opened in three Massachusetts cities Springfield, Beverly, and Boston. Designed to
reduce the risks of relapse, these schools aim to provide education only to students
who are in recovery. As of 2011, at least twenty more recovery high schools have
opened their doors across the United States. * Imagine the impact there would be
if every school around the world were to add addiction prevention classes as a re-
quired course of study before the early adolescence, which is the time children are
most likely to experiment with alcohol and drugs.

What Is A Recovery High School?


Also known as an alternative high school, recovery high schools help students strug-
gling with substance abuse issues to continue with their academic education, while
also participating in an addiction recovery program.

The first school-based prevention programs were primarily informational and often
used scare tactics; it was assumed that if youth understood the dangers of alcohol
use, they would choose not to drink. These programs were ineffective. Today, bet-
ter programs are available and often have a number of elements in common: They
follow social influence models and include setting norms, addressing social pressures
to drink, and teaching resistance skills. These programs also offer interactive and
developmentally appropriate information, include peer-led components, and provide
teacher training. According to the Association of Recovery Schools, teachers and
students will meet the following criteria:

Recovery Schools are of two types. Recovery schools at the secondary level meet
state requirements for awarding a secondary school diploma. Such schools are de-
signed specifically for students recovering from substance abuse or dependency.
Eligible colleges offer academic or residential programs or departments designed
specifically for students recovering from substance abuse or dependency.

Recovery Schools provide academic services and assistance with recovery (includ-
ing post-treatment support) and continuing care. However, they do not generally
operate as treatment centers or mental health agencies.

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Recovery Schools require that all students enrolled in the program be in recovery
and working a program of recovery determined by the student and the School.
Consequences of relapse are addressed and handled according to the policy of
each individual school.

Recovery Schools offer academic courses for which students receive credit
towards a high school or college degree. At the secondary level, Schools assist
students in making the transition into another high school, college or a career.

Recovery Schools are prepared through policies and protocols to address the
needs of students in crisis, therapeutic or other. These procedures can involve:

1. Full-time or part-time licensed counselors on staff;

2. Outsourced counseling contracts through which a specific outside agency


consults with staff in the event of a student crisis or relapse. This is a good
example of a collaborative effort and/or wraparound service involving profes-
sionals and family members working together on the youths behalf.

Using Springfield Recovery High School as an example as to how recovery high schools
operate, the following program criteria applies

The mission of the Recovery School is to provide a high quality academic experience
in a safe, therapeutically supportive school setting to high school students in recov-
ery from substance use disorders. Studies indicate that without intense support, an
extremely high percentage of teens in recovery relapse.

The goals of the program are to:

1. Recruit and retain a population of 30 to 50 students.

2. Offer the Massachusetts High School Curriculum Frameworks in all domains.

3. Provide the opportunity for students to graduate from the Recovery High School
and enroll in college or a vocational training school, enter the military or enter
the work force. Students may earn a high school diploma from the City of Spring-
field or from their home school district.

4. Support students in maintaining their recovery.

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The professional staff of the program includes a program director who is a licensed
principal as well as a licensed psychologist; an assistant principal who supervises the
day to day operation of the program; four licensed content area teachers (English,
Mathematics, Science and Social Studies); a licensed social worker/school adjust-
ment counselor; a licensed guidance counselor; a Special Education teacher; and a
school nurse. In addition to being licensed and trained in their professional areas,
all staff members have received additional experience and/or training in substance
abuse prevention or treatment.

The recovery support component of the program is multifaceted. There are recovery
support activities built into the daily schedule. These activities will be implemented
by both Recovery School staff and also by substance abuse professionals from the
community. Students are also expected to participate in a recovery support program
in the community. Students who experience a relapse may be required to enter a
treatment program in order to continue enrollment in the Recovery School.

A School/Family/Community Advisory Board meets monthly in order to assist in the develop-


ment of policy and procedures as well as to problem solve various issues that might arise.

Families are expected to be involved in their childs participation in the Recovery


School. There is an on-going family support/education group, which meets every 2
weeks on Monday evenings between 5:30 - 7:00 p.m. Parents are invited to be part
of the schools advisory board. As discussed in Module 5, families play a critical role
in the childs wraparound approach to recovery.

The National Surveys on Drug Use & Health, conducted by the Substance Abuse and
Mental Health Services Administration (SAMHSA), found the following:

59.7% of adolescents aged 1217 have experimented with inhalants and had an
even earlier history of smoking cigarettes.

67.6% have tried alcohol.

42.4% have tried marijuana.

35.9% had smoked cigarettes, and experimented with alcohol and marijuana prior
to experimenting with inhalants.

Adolescents have the highest susceptibility to substance abuse of any population.

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The two primary genetic factors that influence higher susceptibility to abuse/depen-
dency in adolescents include:

1. Predisposition related to genetic and hereditary factors in family.

2. Delay in adolescent neurological development responsible for impulse control,


inhibition, reasoning and judgment.

Environmental factors, like the influence of parents and peers, play a role in alcohol
use. For example, parents who drink more and who view drinking favorably may have
children who drink more, and an adolescent girl with an older or adult boyfriend is
more likely to use alcohol and other drugs and to engage in delinquent behaviors.

General Susceptibility factors and facts include:

The earlier a person starts drinking, the higher the likelihood that he or she will
become dependent upon drugs or alcohol as an adult.

Adults who report that they first used alcohol before age 15 are more than 5
times as likely to report past-year alcohol dependence or abuse than persons who
first used alcohol at age 21 or older (SAMHSA, NSDUH, 2004).

The inverse is also true: Every year use of a substance is delayed, the risk of
developing a substance abuse disorder decreases substantially (Winters, 2004).

Consequences
The brain changes dynamically during adolescence and early use of alcohol can seri-
ously impair these growth processes and hinder academic ability.

Social skills can also be impaired as a direct result of substance abuse. Its been
proven that a childs emotional maturity growth is halted for the period of time he
or she is involved in substance abuse activity. For example, if a child develops an
alcohol dependence problem at the age of fourteen and quits drinking twenty years
later, the now 34-year old adult will exhibit an emotional maturity level of a four-
teen year old. He or she will also lack the social and other cognitive skills required
to function as a normal adult and these skills must be learned and/or re-learned.

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Recent research to evaluate the cognitive functioning of alcohol-dependent adoles-


cents has found evidence of impaired memory, altered perception of spatial relation-
ships, and deficiencies in verbal skills. These negative cognitive effects may cause
alcohol-dependent adolescents to fall behind in academic performance, which can
induce an unfortunate downward spiral. (NIDA, 2003; Brown et al., 2000). A fourteen
year old student that continues to use drugs on a regular basis will often fall so far
behind in their academic studies that they are either forced to repeat the school
year or drop out of school altogether. Its not uncommon for a student to choose the
latter option at age sixteen, just two short years after they began to abuse drugs or
alcohol. Dropping out of society as a teenager only digs a deeper hole for the child
and many eventually fall through the cracks and drop out of adult society, as well.

Research using sophisticated imaging tests also suggests that alcohol consumption
during adolescence may have a permanent adverse effect on the growth and devel-
opment of the hippocampusa part of the brain important for learning and memory
(NIDA, 2003; De Bellis et al., 2000). The hippocampus is particularly important
in forming new memories and connecting emotions and senses, such as smell and
sound, to memories. One of the most common responses that long-term alcoholics/
addicts report when they first quit drinking or using is that they feel numb to their
emotions. One would think that hitting bottom, losing nearly everything important in
a persons like, such as a job, family, money, etc., and waking up in rehab, for ex-
ample, would raise all sorts of emotions. But most long-term addicts and alcoholics
feel empty inside and dont understand the reason for it. It partly happens because
of the damage done to the hippocampus area of the brain, which is particularly im-
portant in forming new memories and connecting emotions and senses, such as smell
and sound, with memories. Its as if a tape recorder had been recording all sorts of
memories, learning experiences and emotions for the first 14-15 years of the per-
sons life, but the stop button was pushed when the adolescent or child first began
using drugs or alcohol. While pre-substance abuse childhood memories and learning
experiences remain fairly easy to recall, the active addiction years are simply a blur
for most recovering addicts.

Human brain development continues into the third decade of life, raising concerns
that heavy alcohol use during adolescence may produce disproportionately greater
cognitive deficits among adolescents relative to adults.

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Underage Drinking as a National Priority


The Leadership To Keep Children Alcohol Free Foundation, a unique coalition of
current and former Governors spouses, Federal agencies, and public and private
organizations, is an initiative to prevent the use of alcohol by children ages 9 to 15.
It is the only national effort that focuses on alcohol use in this age group. It is also
the oldest and largest organization of Governors spouses focused on a single issue.

Alcohol Statistics
Alcohol is the most commonly used and abused drug among youth in the United
States, more than tobacco and illicit drugs. Although drinking by persons under the
age of 21 is illegal, people aged 12 to 20 years drink 11% of all alcohol consumed in
the United States.1 Early-onset underage drinking has been linked to alcohol-related
problems not only during adolescence but also in adulthood. Some facts presented
by Dr Ralph Hingson, ScD, MPH, Division of Epidemiology and Prevention Research,
National Institute on Alcohol Abuse and Alcoholism, in a 2009 commentary titled The
Legal Drinking Age and Underage Drinking in the United States are listed below.

On an average day in the US, nearly 8,000 children ages 12 to 17 begin to drink.

High school students who use alcohol or other drugs frequently are up to 5 times
more likely than other students to drop out of school.

Underage alcohol use is more likely to kill young people than all illegal drugs combined.

More than 1,700 college students between the ages of 18 and 24 in the U.S. are
killed each yearabout 4.65 a dayas a result of alcohol-related injuries. Nearly
599,000 students in this age group each year are unintentionally injured while
under the influence of alcohol.

Underage drinkers tend to drink heavily, on average 5 drinks per occasion at a


frequency of 6 times per month.

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Frequent binge-drinking high school students (almost one million in the United
States) are more likely to engage in a variety of high-risk behaviors when intoxi-
cated. They are more likely to drive after drinking, ride with drinking drivers, never
wear seat belts, carry weapons, and become injured due to physical fights and
suicide attempts. They also are more likely to engage in unplanned and unprotected
sex, use illicit drugs, drink and use illicit drugs on school property, and have poor
academic performance.

Cognitive damage is not the only consequence of underage drinking


Underage drinking is a factor in nearly half of all teen automobile crashes and the
leading cause of death among teenagers. Alcohol is linked to over 5,000 automobile
deaths each year for those under the age of 21.

Alcohol use contributes to youth suicides, homicides, and fatal injuries. In 2000,
youths ages 12 to 17 who reported past-year alcohol use (19.6%) were more than
twice as likely as youths who did not (8.6%) to be at risk for suicide during this time
period. In 2006, 1.4 million youth ages 12 to 17 needed treatment for an alcohol
problem. Of this group, only 101,000 of them received any treatment at a specialty
facility, leaving an estimated 1.3 million youths who needed help, but did not re-
ceive treatment.

As many as two-thirds of all sexual assaults and date rapes of teens and college
students are linked to alcohol abuse.

Alcohol is a major factor in unprotected sex among youth, increasing their risk of
contracting HIV and other sexually transmitted diseases (Stueve & ODonnell, 2005).

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Legal and Regulatory Issues


The use of alcohol and other drugs by students is strictly forbidden on school grounds,
as is the unlawful possession, use, or distribution of illicit drugs and alcohol on school
property or at any school sponsored activities by either students or school employees.
Jail sentences carry a harsher punishment for those convicted of supplying drugs
within and adjacent to a school zone.

Some activities are illegal for everyone, regardless of age. These include the use of
illicit drugs and also illegal types of gambling.

Some activities are legal for adults but not for minors. Minors may not buy alcohol and
tobacco, and adults may not sell these to minors.

Minors may not participate in even legalized gambling.

Some substances may be used legally at any age for their intended purpose, but not
otherwise. Cough medicines containing codeine to get high are one example of a legal
substance that can be abused by people of any age.

Legal medications, whether prescription or over-the-counter, may not be abused. For


example, Sudafed and other cold medicines used in the production of methamphet-
amine can only be purchased from a pharmacist on duty in most states. These types
of medicines were previously available off the shelf, but have been restricted in an
effort to reduce the methamphetamine production problem in the United States, as
well as other countries around the world.

Substances with volatile solvents, whether medicinal or industrial, may be used as


directed, but it is illegal in some states to possess, buy, sell, or inhale them with the
intent of causing intoxication. Laws prohibiting the sale of spray paint to minors have
been passed in some states. While the primary reason for these laws was to prohibit
graffiti activity, there has also been a concern over children purchasing spray paint
as an inhalant. Spray paint has been proven to cause serious brain damage, as well
as damaging to the kidney, liver, and other vital organs. The high users experience
from spray paint, toluene, and other industrial chemicals results from a lack of oxy-
gen to the brain.

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Categories of Abuse
Tobacco
Smoking is the leading preventable cause of death in the United States. An estimated
440,000 people die from smoking cigarettes every year. Based on the current smoking
rate in America today, over 6,000,000 children currently under the age of eighteen
will die from smoking.

Tobacco Use in the USA


High school students who are current (past month) smokers: 19.5% or 3.4 million
[Boys: 19.8% Girls: 19.1%]

High school males who currently use smokeless tobacco: 15.0% [Girls: 2.2%]

Kids (under 18) who try smoking for the first time each day: 4,000

Kids (under 18) who become new regular, daily smokers each day: 1,000+

Kids exposed to secondhand smoke at home: 15.5 million

Workplaces that have smoke-free policies: 75.1%

Packs of cigarettes consumed by kids each year: 800 million (roughly $2.0 billion
per year in sales revenue)

Adults in the USA who smoke: 19.3% or 45.8 million [Men: 21.5% Women: 17.3%]

The cost of health care for people in the state of Massachusetts with smoking-re-
lated illnesses exceeds $2.7 billion a year. The combined cost of public and private
smoking-related medical care exceeds $96 million dollars in the United States.

Smoking is a major risk factor for heart disease and stroke, chronic bronchitis, em-
physema, and cancers of the lung, larynx, pharynx, mouth, esophagus, pancreas,
and bladder.

Students who smoke are also at higher risk for contracting colds, bronchitis, and
triggering asthmatic symptoms, and therefore have increased absenteeism due to
illness (Massachusetts Department of Education, 2000).

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Statistics indicate that adolescents are the most vulnerable to the addictive at-
traction of cigarettes.

According to the Center for Disease Control (CDC), 80% of tobacco users began
smoking as teens.

A single exposure to nicotine can produce changes in the developing brains of


adolescents.

Adolescents are more receptive than adults to the rewarding effects of nicotine
and the chemicals with which it combines in cigarette smoke.

Adolescents may not feel the negative effects of nicotine as strongly as adult.\

Adolescents with ADHD may turn to smoking as a form of self-medication.

The use of smokeless or spit tobacco, including chewing tobacco or snuff, is


not a safe alternative to smoking.

Smokeless tobacco has been determined to be highly addictive, and its use has
been linked to cancers of the head.

The smoking of flavored tobaccos through water pipes has become popular among
young people, who are often mistakenly assuming that water filtration makes
smoking safer.

Users of water pipes inhale dangerous amounts of carbon monoxide, nicotine,


and tar, and that smoking through a water pipe causes lung disease, cardiovascu-
lar disease, and cancer.

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Other Drugs of Abuse | Oxycodone (OxyContin, Percoset)


Prescription drug abuse has become the fastest growing addiction epidemic in the
Unites States in recent years and continues to grow at an alarming rate. Here are
some statistics regarding Oxycontin alone. Its important to remember that this is
just one of many prescription drugs available to youths on the street.

OXYCONTIN Addiction Fact 1


OXYCONTIN abuse and OXYCONTIN addiction, according to the National Institute
of Health, impacts all Americans, because we all pay the cost for it.

OXYCONTIN Addiction Fact 2


Statistics show that OXYCONTIN abuse and OXYCONTIN addiction cost Americans
over $484 billion annually. This figure includes healthcare costs (and abuses of
that system), lost job wages, traffic accidents, crime and the associated criminal
justice system costs.

OXYCONTIN Addiction Fact 3


According to the National Highway Traffic Safety Administration, approximately
10 to 22 percent of car crashes involved drivers who have been using drugs.

OXYCONTIN Addiction Fact 4


OXYCONTIN use and addiction is linked to at least half of the major crimes in this
country, as at least half of the suspects arrested for violent crimes, such as homi-
cide and assault, were under the influence of drugs when they were arrested.

OXYCONTIN Addiction Fact 5


Stress is a major factor in OXYCONTIN use and abuse.

OXYCONTIN Addiction Fact 6


Sadly, nearly two-thirds of people in OXYCONTIN abuse treatment report that
they were physically or sexually abused as children. Child abuse is a major con-
tributing factor to OXYCONTIN addiction.

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Drug Abuse Facts


Every day, 2,500 youth between the ages of 12 and 17 abuse a prescription pain
reliever for the very first time.

Sales of opioid painkillers to pharmacies and health care providers have increased
by more than 300 percent since 1999.

Since first hitting the market in the mid-1990s, Oxycontin has risen to become
one of the nations top-selling prescription painkillers, with worldwide sales
totaling $3.6 billion in 2010.

In 2010, one in every 20 people in the United States age 12 and older a total of
12 million people reported using prescription painkillers non-medically.

Again, keep in mind that Oxycontin is just one of many opioid prescription drugs
on the market and does not include the following commonly abused drugs:

Propoxyphene (Darvon)
Hydrocodone (Vicodin)
Morphine
Hydromorphone (Dilaudid)
Meperidine (Demerol)
Diphenoxylate (Lomotil)
Pentobarbital sodium (Nembutal)
Benzodiazepines
Diazepam (Valium)
Alprazolam (Xanax)
Methamphetamine
Dextroamphetamine (Dexedrine)
Methylphenidate (Ritalin)

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General Signs and Symptoms of Substance Use or Abuse


Changes in eating habits, including loss of appetite or increase in appetite. Metham-
phetamine users generally eat less than normal, while marijuana users often develop
a voracious increase in appetite known as the munchies.

Unexplained weight loss or gain

Slowed or staggering gait could be symptoms of alcohol, heroin and sedatives

Poor physical coordination

Inability to sleep, awake at unusual times; Insomnia or periods of sleeplessness fol-


lowed by long periods of catch up sleep

Unusual laziness; Loss of interest, motivation; Difficulty concentrating

Red, watery eyes; pupils larger or smaller than usual; blank stare; Glassy, bloodshot eyes

Cold, sweaty palms; trembling hands

Puffy face, blushing, or paleness

Loud talking and inappropriate laughter; Excessive talking, rapid speech

Change in body odor

Excessive thirst (known as cotton mouth)

Avoidance of eye contact, especially when challenged about use

Jumpy, nervous behavior, and restlessness

Runny nose or bloody nose; Vomiting; Coughing and sniffling (with no associated cold
or other illness)

Periods of high energy followed by long sleep or exhaustion

Unusual elation (manic) or depression

Fast or incoherent speech

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Significant change in mood

Poor attention span; Difficulty concentrating

Drunk demeanor without accompanying odor of alcohol

Unusual or inappropriate euphoria; Irritability; Anxiety

Excessive talking followed by depression or excessive sleeping at odd times

Bizarre and irrational behavior, including paranoia, aggression, or hallucinations

Detachment from people

Absorption with self or other objects withdraws into own private world, be-
comes reclusive

Needle marks

Sweating

Facial rash

Blister, rashes, or soreness around the nose, mouth, and/or lips

Frequent unexplained coughing

Headaches

Hand tremors; Poor muscle control

Uncontrolled laughter

Grandiose and hostile speech; Increased irritability and anger

Bizarre risk-taking

Violent outbursts

Discarded product containers such as bags, rags, gauze, or soft drink cans used to
inhale the fumes

Traces of odors of paint, gasoline, or solvents

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It has been found that schools that incorporate the following strategies have effec-
tively reduced self-reported student substance abuse (Learning First Alliance, 2001):

Fostering positive and supportive adult-student relationships.

Fostering positive peer relationships with fellow students in recovery. There is


strength in numbers and bonding with groups of like-minded classmates is very
important to the recovery and relapse prevention process.

Emphasizing student involvement in decision-making (in school governance,


instruction on social and communication skills, cooperative problem solving, goal
setting). This approach fits well with the recovery coaching philosophy of making
the recovering addict an active participant in his/her own recovery program.

Promoting a school climate that respects and celebrates cultural differences. A


united vs. individual atmosphere and taking steps to avoid an us against them
mentality plays an important role in any group setting, including recovery schools.

Providing information regarding addiction treatment programs and staff support


for students involved in such programs. Teenagers are easily bored and restless. If
teachers, staff members and recovery coaches can help them to find after school
or evening youth support groups, healthy acitivites, or 12 Step meetings, etc.,
the chance of staying off the streets and out of trouble is much greater than for
those with no guidance.

Training students, faculty and staff members in substance use prevention poli-
cies; and providing skill-based instruction, including devoting class time for skill
practice. Teaching kids how to replace old, destructive habits with new, healthy
hobbies, skills and activities is far more effective than lecturing them about the
dangers of alcohol and drugs. As a trained recovery coach, this approach is right
up your alley.

An ounce of prevention is better than a pound of cure.


Benjamin Franklin.

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Coaches Role | Adult or Peer Coaching


Recognize that the potential impact of specific risk and protective factors associated
with drug abuse changes with age, so drug prevention education must be tailored for
grade level. The age at which children begin using drugs or alcohol carries important
implications as to how many will develop a high likelihood for full-blown addiction
problems down the road, as shown below

In 2007, among adults aged 18 or older who first tried marijuana at age 14 or young-
er, 12.9 percent were classified with illicit drug dependence or abuse, higher than
the 2.7 percent of adults who had first used marijuana at age 18 or older.

Among adults, age at first use of alcohol was associated with dependence on or
abuse of alcohol. In 2007, among adults aged 18 or older who first tried alcohol at
age 14 or younger, 15.9 percent were classified with alcohol dependence or abuse
compared with only 3.9 percent of adults who had first used alcohol at age 18 or
older. Adults aged 21 or older who had first used alcohol before age 21 were more
likely than adults who had their first drink at age 21 or older to be classified with
alcohol dependence or abuse (9.6 vs. 2.2 percent)

As a recovery coach, you will need to stay abreast of the best techniques to use with
each age group and customize your action plan to best suit the child or youth based
on their current age. Learning to speak in the clients preferred language is important
when engaging with any client and this is especially true when working with teenagers.

Pre-adolescent risk factors are greatest within the family (when family members
have addictions). Its been proven that children growing up with parents that use
drugs or alcohol have a much greater chance of developing a substance abuse
problem of their own. Emotional and physical trauma is another important factor to
consider. As a general rule, children raised in safe, loving environments show a far
lower level of substance abuse issues than those in a dysfunctional home. As pointed
out earlier, 70% of people suffering with Oxycontin addiction reported that they
were physically or sexually abused as children.

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Recognize that for adolescents the association with drug-abusing peers and misper-
ceptions of the extent and acceptability of drug-abusing behaviors in school, peer,
and community environments are the most significant risk factors. A childs peer
group can greatly impact his or her decision-making process, especially children suf-
fering with a poorly developed sense of self-esteem or self-worth.

Coaches use the Four Es to encourage and empower teenagers to pursue healthy
activities and interests Engagement, Empathy, Encouragement and Empowerment.
Learn to communicate with adolescents in their own language and to establish a
bond of trust with them. Empathy and sympathy mean different things. While sym-
pathy is feeling pity for someones plight or situation, empathy involves the ability
to relate to the situation or issues your clients are experiencing.

Motivational interviewing techniques and intense listening skills allow coaches to


identify the clients issues and barriers, as well as identifying strengths.

Have knowledge of all substances of abuse because adolescents often abuse more
than one substance and/or progress from substances such as alcohol or tobacco
to illegal drugs, inhalants, prescription medications, or OTC drugs. Its not at all
uncommon for adolescents to snort, drink, inhale or swallow anything that prom-
ises to make them feel good. While adults can buy alcohol legally, for example, a
teenager is limited to whatever is cheap, quick and easily available.

Focus on adolescents social and academic skills, including enhancing peer re-
lationships, self-control, coping skills, social behaviors, and drug-offer refusal
skills. Again, encouragement and empowerment lead to efficacy and personal
power for both children and adults alike. Recovery coaches simply adapt the
action plan to include steps suited to the adolescents wants and needs when
working with this age group. Kids with clear goals and a strong sense of efficacy
feel far more empowered to say no to drugs and other high-risk, illicit activity
than their opposites.

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Promote feelings of self -efficacy in their clients. This one bears repeating - kids
that feel a strong sense of self-worth, surround themselves with positive activi-
ties and feel empowered in life rarely show an unhealthy interest in drugs and
alcohol. The opposite holds true for those that feel powerless, suffer from low
self-esteem, and lack a sense of direction in life. The importance of teaching
children how to feel good about themselves cannot be overstated.

Increase emotional awareness in their clients. If a child lives in an unhappy


home, its okay for he or she to feel angry, sad, or fearful about the situation,
as long as its done in a healthy way. As a recovery coach, its your job to engage
with your client and encourage them to express emotions, as well as create steps
designed to help the child overcome barriers.

Provide accurate, fact-based information about short-term and long-term health


effects of substance abuse/addiction. Teenagers tend to believe they are invin-
cible, bullet-proof, and that they will live forever. While fear tactics are never a
good idea, when dealing with others, presenting teenagers with the facts about
tobacco, drugs and alcohol is always a good idea.

Foster the development of norms that make substance abuse unacceptable and
unpopular through role modeling and mentoring youth. Forty years ago, drinking
and smoking cigarettes was considered normal behavior by much of society. As
public awareness has increased about the dangers or substance abuse, however,
smoking, drinking and driving, and other behaviors that once seemed acceptable
have changed dramatically. Recovery coaches help clients identify and achieve
goals based on the clients values. Helping to introduce a child to a healthy set of
values can play a huge role in the childs future behavior.

Disprove the notion that the majority of students experiment in risky behavior.
Less than 30% of adolescents engage in any type of serious risky behavior and
the numbers drop considerably for those involved in regular, continuous high-risk
behavior. One way to teach a teenager that not everyone he knows is into drugs
or alcohol might be to ask him how many students he knows from school and how
many of them he sees drinking or using drugs on a regular basis. If there are 300
students in his school, but he can only count 20-30 in his substance abuse circle,
he will realize that substance abuse is not a normal, socially acceptable activity.

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Encourage positive, supportive, sustained connections between youth and coaches.


Engage, engage, engage with your youth clients. The minute any teenager views a
coach as phony, boring, or disinterested, he or she will disappear and never return.
Build a relationship based on genuine interest and trust between the two of you
and you might just find your youthful client will not only appreciate your help, but
will value the relationship with you long after he or she is married and raising their
own children.

Include activities that provide youth with opportunities to role-play or use newly
learned skills. Nothing teaches us empathy more than walking a mile in someone
elses shoes. For example, very few teenagers would bully others if they were
able to view the situation from the victims eyes. Role playing can help kids to
step outside their own limited view of others and gain valuable skills, such as
supporting others and expressing empathy.

Develop linkages to other community/virtual resources as necessary. Most news-


papers include a community section, where all sorts of hobbies, educational,
self-help and other activities are listed. These events can be offered as an ex-
tremely therapeutic resource for kids in recovery.

Provide prevention programs for preadolescents and adolescents. Sports, music


lessons, fundraisers, writing or art classes are just a few programs designed for
kids of all ages. Help your clients to connect with them.

Improve study habits, with academic support. thereby promoting feelings of


success and empowerment. Recovery coaches arent schoolteachers or private
tutors, but can devise steps in the childs action plan designed to implement
improved study skills. If the child is struggling with a particular school subject,
for example, one of the action plan steps might include asking the teacher for
extra help or a trip to the library to learn more about the subject.

Improve attendance rates as a by-product of goal directed services. If a child has


learned to complete homework assignments or has discovered a new interest in
history or science class because of action plan steps, he or she is going to be far
more interested in attending school than a child that is ill-prepared.

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Enhance communication skills, improving self-efficacy and assertiveness to en-


hance drug resistance skills.

Strengthen positive peer relationships.

Present educational sessions for students, parents, school committees, and com-
munity members.

Recognize that adolescents have the same rights and responsibilities as adults
with regard to making choices about their care. Just because adults are more
experienced in life than children does not mean they deserve to be treated with
less respect than us. Communicating with the child on the childs level empowers
them to not only express their right to assert themselves, but to accept responsi-
bility for their own part in the recovery process, as well.

Engage and empower their clients to be full partners in their own care.

Understand the significance of just knowing that there is somebody there who
understands, and who has got their back. Who doesnt want to feel that we have
a friend to watch our back? AA meetings and other support groups exist for that
very reason to know there are others that support us when we are weak and
fragile. If it works for adults, just imagine how well it will work for a teenaged
child that might feel voiceless, lost and alone.

Coaches can use this knowledge as the basis for creating a new sense of hope and
possibility for their clients.

Take every opportunity to learn their clients strengths, interests and needs from
their perspective. We are recovery coaches learning our clients strengths,
interests, wants and needs is the most important part of our job. Learn to be the
best at what you do and nearly every child will appreciate you for it.

Support their clients to voice their concerns and wants with their service pro-
viders and families. Kids are often dismissed by adults, especially by authority
figures, and feel powerless to speak for themselves, as a result. Help them learn
how to speak on their own behalf, rather than speaking for them.

Often act as a role model and mentor for the clients that they work with.

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Have the flexibility to meet their clients where they feel comfortable, and to
participate in activities ranging from meeting for lunch or going shopping to
meeting at family court or at the youths school. If you turn up at your clients
school play or musical concert on a Tuesday evening, you will have earned a
friend for life.

Utilize technology to enhance services and reach clients in their world. Using
sites such as Facebook or tools such as Instant messaging, Text, MMS, and Skype.

Provide presentations on issues of concern to youth, families and providers such


as gang involvement and youth engagement. Advocate, advocate, advocate for
the safety and best interests of the people you represent and tailor those advo-
cacy practices to your clients age group.

Are familiar with organizations of independent self-described youth advocates


like the National Youth Rights Association (NYRA), Youth Advocates for Communi-
ty-Based Treatment (Youth ACT), the National Youth Leadership Council (NYLC) or
local chapters of the Federation of Families for Childrens Mental Health.

Recognize the significance of listening, engagement, collaboration and bound-


ary setting as the basis for discovering their clients needs and a starting place
for giving voice to their clients concerns. While you most likely have a working
understanding of the first three words, be sure to know when to establish bound-
aries, when necessary. Remember, you are the adult and the mentor with teenage
clients and carry the responsibility to act as such at all times.

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CRAFFT Screening Instrument for Adolescents


The impact The CRAFFT tool was developed specifically for adolescents by the Cen-
ter for Adolescent Substance Abuse Research at Childrens Hospital Boston. The tools
name helps to remind the screener of the 6 questions it includes, as shown below.

The CRAFFT is very brief and easy to score: 2 yes answers indicate a need for fur-
ther assessment, while 4 yes answers indicate dependence (Knight et al., 2003).

Studies have shown that scores on the CRAFFT screening tool have a high correlation
with measures of substance abuse and dependence.

Have you ever been a passenger in a Car driven by someone (including yourself)
who was high or had been using alcohol or drugs?

Do you ever use alcohol or drugs to Relax, feel better about yourself, or fit in?

Do you ever use alcohol or drugs while you are by yourself, Alone?

Do you ever Forget things you did while using alcohol or drugs?

Do your Family or Friends ever tell you that you should cut down on your drinking
or drug use?

Have you ever gotten into Trouble while you were using alcohol or drugs?

Exhibits 14-5 through 14-7 provide sample guidelines and checklists for screening
of students suspected of alcohol or drug use.

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Useful Websites
Oxy Watchdog
http://oxywatchdog.com/rx-stats/

Association of Recovery Schools


http://www.recoveryschools.org/index.html

Leadership To Keep Children Alcohol Free Foundation


http://www.alcoholfreechildren.org/

American Council for Drug Education (ACDE)


164 West 74th Street, New York, NY 10023
800-488-DRUG (3784)
acde@phoenixhouse.org
http://www.acde.org/Default.asp
ACDE is a substance abuse prevention and education agency that develops programs
and materials based on the most current scientific research on drug use and its
impact on society.

CheckYourself.com
Partnership for a Drug-Free America
Website: http://checkyourself.com
CheckYourself.com offers older teens an opportunity to think in a focused way about
their relationship with drugs and alcohol and invites them to consider whether their
substance use risks turning into a problem for them.

The Cool Spot


National Institute of Alcohol Abuse and Alcoholism (NIAAA)
Website: http://www.thecoolspot.gov
The Cool Spot, the young teens place for info on alcohol and resisting peer pres-
sure, is a website created for kids aged 1113 by NIAAA.

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References
Recovery High School Listing
http://www.recoveryschools.org/schools_highschool.html

Lombrowski, B., Griffin-Van Dorn, A., & Castillo, M. (2008).Youth advocates: What
they do and why your wrap around program should hire one. I.J. Bruns & J. S. Walker
(Eds.), The resource guide to wraparound. Portland, OR: National Wraparound Initia-
tive, Research and Training Center for Family Support and Childrens Mental Health.
Chambers & Potenza, 2003; Chambers, Taylor & Potenza, 2003; Winters, 2004).

Office of National Drug Control Policy, 2006). (CASA, 2003). The Second Edition of
the National Institute on Drug Abuse publication, Preventing Drug Use Among Chil-
dren and Adolescents: A Research-Based Guide for Parents, Educators and Community
Leaders.

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